Naslov
Human and epidemiological data - including endemic nephropathies

Autori
Fuchs, Radovan ; Peraica, Maja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, pregledni

Izvornik
Working document of Workshop on ochratoxin A in food: recent developments and significance / Walker, Ron - Brisel : ILISI, 2005

Skup
Workshop on Ochratoxin A in food: recent developments and significance

Mjesto i datum
Beč, Austrija, 29.06.2005. - 01.07.2005

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
ochratoxin A; endemic nephropathy; mycotoxin

Sažetak
Ochratoxin A (OTA) is nephrotoxic and carcinogen product of moulds. In the early seventies the hypothesis of its involvement in the etiology of endemic nephropathy (EN) was put forward. EN is human interstitial bilateral noninflammatory kidney disease with fatal outcome that occurs in farmers’ households in geographically limited rural areas of Bosnia and Herzegovina, Bulgaria, Croatia, Rumania, Serbia and Montenegro. The prevalence of EN in Bulgaria, Serbia and Montenegro, and Croatia after the peak at early seventies has declining trend. Ten years after this peak, a high incidence of otherwise rare urothelial tumors was first noticed in the endemic area of Bulgaria, and then of other countries. These tumors are often multiple, affect mostly upper urothelial tract and show clinical picture different from tumors with the same location in patients out of the EN region. Geographically restricted area of the appearance of EN and these tumors in farmers suggests the possibility of the etiological factor for both diseases is unique, most probably of natural origin. Although OTA was found in dust of grain and coffee in food production facilities, the main source of human exposure is food, because it contaminates food of vegetable and animal origin worldwide. In Bulgaria and Croatia special attention was paid to OTA contamination of various commodities in areas with EN. Thus, in EN area of Bulgaria the OTA contamination of beans and maize showed a high variability in different years, but the mean OTA concentration and the frequency of positive samples was higher than in control areas. In EN region in Croatia, OTA was found in maize, wheat, barley, and beans and in some studies the mean OTA concentration in maize and wheat was reported to be higher in samples collected in EN area than in controls. Large follow-up studies were performed in Croatia and Bulgaria aimed to check whether the inhabitants of EN regions are exposed to higher OTA concentrations than other population. In both countries, albeit the variability of blood OTA concentration from year to year, the mean OTA concentration in inhabitants of endemic villages as well as higher number of OTA-positive samples was seen as compared to other regions. However, OTA was found in food, feed and human blood in countries where EN has not been detected. In Canada, Croatia, France, Sweden, Switzerland, and Tunisia, regional differences of OTA blood concentrations in healthy population have been found. In Croatia blood samples obtained from blood banks showed a seasonal variations in OTA concentrations, and the highest number of OTA positive samples, as well as the highest mean OTA concentration was in samples collected in summer period. OTA was also found in breast milk (Italy, Norway, and Sweden), and in urine (Bulgaria and Croatia) of healthy persons. In Czech Republic, Italy, Spain, and Turkey it was noticed that patients at hemodialysis have higher OTA concentration in blood than patients with other renal diseases or healthy persons. There are several attempts to link exposure to OTA in patients suffering of end stage kidney disease in North Africa with nephropathy.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti, Javno zdravstvo i zdravstvena zaštita

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